Organization Name: | KATHY WILSON ARNP FAMILY NURSE PRACTITIONER AND ASSOCIATES |
NPI Number: | 1073883336 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID BRUNETTE (OFFICE MANAGER) |
Mailing Address: | 322 Racetrack Rd Ne Fort Walton Beach |
State: | FL US |
Postal Code: | 325472546 |
Phone Number: | 8502268588 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2012 |
NPI Last Update Date: | 01/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9162558 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |